Durham Research Methods Centre, Durham University, Stockton Road, Durham, DH1 3LE, United Kingdom; Centre for the Evaluation of Complexity Across the Nexus, University of Surrey, Guildford, GU2 7XH, United Kingdom; Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton Road, DH1 3LE, United Kingdom; Department of Sociology, Durham University, Stockton Road, Durham, DH1 3LE, United Kingdom.
Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
Environ Res. 2022 Dec;215(Pt 2):114362. doi: 10.1016/j.envres.2022.114362. Epub 2022 Sep 18.
Emerging research suggests exposure to high levels of air pollution at critical points in the life-course is detrimental to brain health, including cognitive decline and dementia. Social determinants play a significant role, including socio-economic deprivation, environmental factors and heightened health and social inequalities. Policies have been proposed more generally, but their benefits for brain health have yet to be fully explored.
Over the course of two years, we worked as a consortium of 20+ academics in a participatory and consensus method to develop the first policy agenda for mitigating air pollution's impact on brain health and dementia, including an umbrella review and engaging 11 stakeholder organisations.
We identified three policy domains and 14 priority areas. Research and Funding included: (1) embracing a complexities of place approach that (2) highlights vulnerable populations; (3) details the impact of ambient PM on brain health, including current and historical high-resolution exposure models; (4) emphasises the importance of indoor air pollution; (5) catalogues the multiple pathways to disease for brain health and dementia, including those most at risk; (6) embraces a life course perspective; and (7) radically rethinks funding. Education and Awareness included: (8) making this unrecognised public health issue known; (9) developing educational products; (10) attaching air pollution and brain health to existing strategies and campaigns; and (11) providing publicly available monitoring, assessment and screening tools. Policy Evaluation included: (12) conducting complex systems evaluation; (13) engaging in co-production; and (14) evaluating air quality policies for their brain health benefits.
Given the pressing issues of brain health, dementia and air pollution, setting a policy agenda is crucial. Policy needs to be matched by scientific evidence and appropriate guidelines, including bespoke strategies to optimise impact and mitigate unintended consequences. The agenda provided here is the first step toward such a plan.
新出现的研究表明，在生命关键期暴露于高水平的空气污染对大脑健康有害，包括认知能力下降和痴呆。社会决定因素发挥着重要作用，包括社会经济贫困、环境因素以及加剧的健康和社会不平等。已经提出了更广泛的政策，但它们对大脑健康的益处尚未得到充分探索。
在两年的时间里，我们作为一个由 20 多名学者组成的联盟，以参与式和共识的方法制定了第一个减轻空气污染对大脑健康和痴呆影响的政策议程，包括进行伞式审查并与 11 个利益相关者组织合作。
我们确定了三个政策领域和 14 个优先领域。研究和资金包括：（1）采用一种强调弱势群体的复杂地点方法；（2）详细说明环境 PM 对大脑健康的影响，包括当前和历史高分辨率暴露模型；（3）强调室内空气污染的重要性；（4）列出大脑健康和痴呆的多种疾病途径，包括最易受影响的途径；（5）从生命全程角度考虑；（6）彻底重新思考资金问题。教育和意识包括：（7）让公众认识到这一未被识别的公共卫生问题；（8）开发教育产品；（9）将空气污染和大脑健康与现有的战略和运动联系起来；（10）提供公众可用的监测、评估和筛选工具。政策评估包括：（11）进行复杂系统评估；（12）进行共同制定；（13）评估空气质量政策对大脑健康的益处。
鉴于大脑健康、痴呆和空气污染的紧迫问题，制定政策议程至关重要。政策需要与科学证据和适当的准则相匹配，包括优化影响和减轻意外后果的定制策略。这里提供的议程是制定这样一个计划的第一步。
